Melissa Ann Peterson, MSW, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

150.109431 Issued in IL

Practice address

16614 W 159TH St Ste 302
Lockport, IL 60441-8009

Phone

(708) 341-1452

NPI assigned

Oct 23, 2023

Last updated

Oct 23, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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  • NPI 1962822346
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1698019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1801668009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16627 DORCHESTER PL",
            "city": "LOCKPORT",
            "state": "IL",
            "postal_code": "604416010",
            "telephone_number": "708-421-0975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16614 W 159TH ST STE 302",
            "city": "LOCKPORT",
            "state": "IL",
            "postal_code": "604418009",
            "telephone_number": "708-341-1452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "credential": "MSW, LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-23",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150.109431",
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "IL",
            "license": "319534",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tejal Nanubhai Patel, PA-C
• Viray Lalit Patel, DDS
• Monica Patla, MHS
• Patricia H. Simpson, O.D., LTD.
• Dena M Perillo
• Natalia Maria Petravicius, M.S. CCC-SLP
• Karen Lynn Pfeiffer
• Vidit Atul Phanse
• Phoenix Rising Transformational Wellness PLLC
• Amanda R Pieper

• Social Worker in Lockport, IL
• Providers in Lockport, IL by specialty
• Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.